Volume 5, Issue 3, p. 34–37, December 2022
Doi: https://doi.org/10.32435/envsmoke.20225334-37
Environmental Smoke, e-ISSN:
2595-5527
“5 years spreading quality
science to all who seek a source of interdisciplinary knowledge”
Short
Communication:
SURGICAL REPORT OF A
NEPHRECTOMY IN A CANINE PATIENT
Grazielly Diniz Duarte1* (https://orcid.org/0000-0003-2690-2590); Gil
Dutra Furtado1,2 (https://orcid.org/0000-0001-5611-4814); Martin
Lindsey Christoffersen3 (https://orcid.org/0000-0001-8108-1938)
1UNINASSAU/PB – Maurício de Nassau
University Center, João Pessoa, Paraíba, Brazil
2COOPAGRO – Cooperative of Technical Services of Agribusiness [Cooperativa de Serviços
Técnicos do Agronegócio],
Natal, Rio Grande do Norte, Brazil
3UFPB –
Federal University of Paraíba, CCEN – Center of Exact and Nature Sciences, DSE
– Department of Systematics and Ecology, João Pessoa, Paraíba, Brazil
*Corresponding author: grazielly_jp@hotmail.com
Submitted
on: 15 Oct. 2022
Accepted
on: 14 Dec. 2022
Published
on: 31 Dec. 2022
License:
https://creativecommons.org/licenses/by/4.0/
Surgical intervention in animal patients
affected by different pathologies is indicated so that they will have a better
quality of life. Surgical procedures are now possible due to several advances
in intervention technologies that are developed and updated for veterinary
surgeons. In many cases, promptness in surgical intervention actions is the
line of survival that tutors have available to save the lives of their PETs.
Nephrectomy, which is the surgical removal of a kidney, may often be indicated
as the only way to save the life of an animal patient. Therefore, knowledge
about this surgery is very important. In this report, this surgery and those
effects resulting from this intervention were addressed. We conclude by
establishing the importance that veterinary medical professionals have in
maintaining animal welfare and the importance of always being updated and
centered on improving their surgical skills. Our results demonstrated that the
applied nephrectomy surgery was performed according to expectations.
Keywords:
Kidney removal. Surgery. Veterinarian.
1 Introduction
Presently we observe
a significant number of domestic animals inserted into society. Most belong to
families with quite diverse characteristics: couples without children attribute
parental sentiments to them; lonely people may devote day-to-day companionship
to them; and families with children may adopt animals to entertain their
offspring. There remains a percentage of people, the minority, that have
animals for protection and security of their property. Whatever the role of the
animal, either as a family member or acquired for protection of the owner, animal
holders require that veterinarians become skilled for the well-being of their
pets. Such abilities include health care and maximizing life quality (COSTA,
2014; FURTADO; SILVA; TELES, 2018; FURTADO, 2020; FURTADO et al., 2020).
Veterinary routines
reveal growing care with animals, and increasing concern of owners, ever more
dedicated to the quality of treatment afforded to their pets. The demand for
specialized service thus is increasing in clinics and veterinary hospitals,
permitting animal patients to receive adequate diagnoses and treatment. This
pleases owners and ensures higher success in the recovery of the animal and
extending its life expectancy (FURTADO; SILVA; TELES, 2018).
Within this reality,
nephrectomy is one of the many interventions requiring shrewdness and knowledge
on the part of the veterinary surgeon. It becomes important that the extraction
of one kidney does not impair the quality of life of the animal patient
(CAMPIONE; MANTOVANI, 1998).
The procedure of
nephrectomy varies depending on how the surgery is done and how much of the
kidney is removed (CURY et al., 2008; DAVIS et al., 2013; MALDONADO GOMES et
al., 2013; FERRO et al., 2018). Such variations include:
a. Laparoscopic surgery. In this
minimally invasive procedure, the surgeon makes a few small incisions on the
abdomen in order to insert devices similar to small sticks equipped with video
cameras and small surgical instruments. The surgeon must make a larger incision
when the entire kidney must be removed.
b. Open surgery. In an
open nephrectomy, the urological surgeon makes an incision along or sideways to
the abdomen. This procedure permits interventions that are not entirely safe
under less invasive techniques.
c. Radical nephrectomy. Under
this procedure, the surgeon removes the entire kidney, the adipose tissues that
surround the kidney, and a portion of the tube (ureter) that connects the
kidney to the bladder. The surgeon may remove the adrenal gland located above
the kidney if a tumor is close to or surrounds the adrenal gland. In some
cases, the lymph nodes and other tissues are also removed.
d. Partial nephrectomy. Also known
as a nephron saver surgery. The surgeon removes the cancerous tumor and affects
the tissue but retains as much of the healthy renal tissue as possible.
e. Nephrectomy. The surgical
removal of the kidney and its associated ureter. This surgical procedure is
used to treat irreversible conditions of the kidney and of the ureter. The
conditions treated under nephrectomy include trauma of the kidney and/or
ureter, cancer, ureter anomalies, and persistent infections. Depending on the
case, nephrectomy may represent a primary intervention, in cases such as kidney
cancer not involving metastases, or a measure to prevent more advanced illnesses,
such as a persistent renal infection.
Our aim is to produce
a pedagogical report/tutorial for students in veterinary medicine, using
nephrectomy surgery as an example of a common practice used in dogs.
2 Methodology
Methodology
The report
is based on procedures supervised by duly qualified veterinarians, in order to ensure the success in the intervention and the
best outcome for the canine patient. Procedures for pedagogical report was
based on Gil (2008).
This study
was authorized by ASSVET Ethical Committee, following the ethical standards
according to Law 11.794/2008 of the Ministry of Health of the Federative
Republic of Brazil (BRASIL, 2008).
Study Area
This
report is based on a nephrectomy surgery performed at ASSVET (Veterinary Center
Casa dos Criadores/“Centro
Veterinário Casa dos Criadores”), located in the municipality of João
Pessoa (State of Paraíba, Brazil), Road Barão de
Mamanguape, 150, Torre District. ASSVET is a clinic open 24h/7, providing
specialties such as clinical attendance, urgencies, emergencies, surgeries,
among other.
3 Results and Discussion
Tutorial of nephrectomy
surgery
In this
surgery the right kidney was totally removed. The animal patient was forwarded
to the surgical center after presenting alterations in trial (CAMPIONE;
MANTOVANI, 1998; PICCOLI at al., 2017).
Ventilation
was provided for the patient. The variables monitored were:
electrocardiogram, arterial pressure by oscillometry, oxygen saturation, and
capnography. The latter was verified every 5 min by a multiparametric monitor.
The
surgical incision extended along the median line of the abdomen, from the
xiphoid process to the pubic region. Concomitantly to the removal of cavity
liquid, several organs were inspected, searching for possible causes of
bleeding.
During
renal inspection, the presence of coagula and lacerations of the capsule,
cortex and medulla of the right kidney were observed. The renal hilum was not
affected. Considering the significant commitment of the renal parenchyma, it
was decided to remove the organ, with the nephrectomy technique described by
Rosin (2004). Under this procedure, after the mobilization of the organ to be
removed, the renal hilum was dissected in order to
expose the ureter, renal artery, and renal vein (Illustrations in Appendix 1).
Next the
ureter was dissected to as close as possible to the urinary vesicle. A section
of the ureter was then made between bandages. After the removal of the organ,
the intestines and the greater omentum were returned to anatomical position.
The abdominal cavity was stitched in the usual way.
4 Conclusions
Among the usual practices of a veterinarian,
surgical interventions become increasingly important for the treatment of
animal patients in a critical stage of health. It becomes necessary for
veterinary professionals to become well trained in surgery practices in order to keep up with the best standards of their
profession.
The reported nephrectomy
surgery was a success. It shows that interventions made by qualified
professionals contribute significantly to the well-being and quality of life of
the animal patients under their care. In this way, the pedagogical practices
were quite meaningful for the veterinary students, demonstrating their
enthusiasm in assimilating and learning the content taught during the classes.
CREDIT AUTHORSHIP
CONTRIBUTION STATEMENT
GDD, through actions and research,
participated in the operation practice and the writing of this article. GDF,
with practice in surgeries and pedagogical training, participated in the
methodology and writing of the article, and in the revision of the utilized
data. MLC revised the final text and translated the text into English.
DECLARATION OF INTEREST
The
authors declare no conflict of interest with the participants or collaborators
of this article, either directly or indirectly.
FUNDING SOURCE
No financial contribution was applied for
this article.
Acknowledgements
The authors thank ASSVET Breeder’s House
(Brazil) for their collaboration in the production of this article.
REFERENCES
BRASIL. Lei nº 11.794, de 2008. Regulamenta o inciso VII do § 1º do art. 225 da
Constituição Federal, estabelecendo procedimentos para o uso científico de
animais [procedures for the scientific use of animals]; revoga a Lei no 6.638, de 8 de maio de 1979; e dá outras
providências. Presidência da República: Brasília, 8 oct. 2008.
Available from: http://www.planalto.gov.br/ccivil_03/_ato2007-2010/2008/lei/l11794.htm.
Accessed on: 5 oct. 2022.
CAMPIONE, F.; MANTOVANI, M. Estudo comparativo do
uso de omento, telas de náilon e vicril, no tratamento do trauma renal em cães [Comparative study of the use of omentum,
nylon mesh and vicryl in the treatment of renal
trauma in dogs]. Acta Cirúrgica Brasileira, São Paulo, v. 13, n. 1, p. 1-4. 1998.
Available from: https://doi.org/10.1590/S0102-86501998000100008.
COSTA, S.A.B. Maneio do paciente politraumatizado
na clínica de animais de companhia
[Management of polytrauma in the small animal clinical practice]. 2014.
122f. M.Sc. Thesis (Integrated Master in Veterinary Medicine)
– Faculty of Veterinary Medicine of the University of Lisbon, Lisbon, 2014.
Available from: https://www.repository.utl.pt/handle/10400.5/7577. Accessed on: 4 oct. 2022.
CURY, J.; MESQUITA, J.L.B.; PONTES, J.;
OLIVEIRA, L.C.N.; CORDEIRO, M.; COELHO, R.F. Trauma urológico
[Urologic Trauma]. Revista de Medicina, São Paulo, v. 87, n. 3, p. 184-194, 2008.
Available from: https://doi.org/10.11606/issn.1679-9836.v87i3p184-194.
DAVIS, H.; JENSEN, T.; JOHNSON, A.; KNOWLES,
P.; MEYER, R.; RUCINSKY, R.; SHAFFORD, H. 2013 AAHA/AAFP fluid therapy guidelines
for dogs and cats. Journal of the American Animal Hospital Association,
Lakewood, v. 49, n. 3, p. 149-159, 2013. Available from: https://doi.org/10.5326/JAAHA-MS-5868.
FERRO, S.L.; JÖNCK, F.; CARDOSO, E.; HECKLER,
M.C.T.; RYCHESCKI, M.; WARMLING, B. Nephrectomy in an Australian cattle dog
parasitized by Dioctophyma renale. Acta Scientiae Veterinariae,
Porto Alegre, v. 46, suppl. 1, pub. 255, p. 1-6, 2018. Available from:
https://doi.org/10.22456/1679-9216.85151.
FURTADO, G.D. Programme National de Post-Doctorat:
Recherche interdisciplinaire en gestion environnementale partagée, connectée à
l’extension universitaire [National
post-doctoral program: interdisciplinary research in a shared environmental
management, connected to the university extension]. Environmental Smoke,
João Pessoa, v. 3, n. 2, p. 46-54, 2020. Available from:
https://doi.org/10.32435/envsmoke.20203246-54.
FURTADO, G.D.; SILVA, A.S.; TELES, J.A.A. Estudo do
comportamento e a medicina veterinária da conservação [Behavioral study and the veterinary medicine of
conservation]. Environmental Smoke, João Pessoa, v. 1, n. 2, p.
176-182, 2018. Available from: https://doi.org/10.32435/envsmoke.201812176-182.
FURTADO, G.D.; SOBRAL, F.E.S.; FURTADO, E.M.;
CHRISTOFFERSEN, M.L.; MENDES, T.M. Academic veterinary activity: Removing
organs from an animal during necropsy. Environmental Smoke, João Pessoa,
v. 3, n. 2, p. 80-85, 2020. Available from:
https://doi.org/10.32435/envsmoke.20203280-85.
GIL, A.C. Métodos
e técnicas de pesquisa
social. 6. ed. São Paulo: Atlas, 2008. Available from:
https://ayanrafael.files.wordpress.com/2011/08/gil-a-c-mc3a9todos-e-tc3a9cnicas-de-pesquisa-social.pdf. Accessed on: 4 oct.
2022.
MALDONADO GOMES, E.; MACHADO, A.; ASTRANA,
M.; CERATTI, G.; FELIPE DUTRA CORRÊA, L.; DOS SANTOS BRUM, D. Relato de Caso: Nefrectomia no
rim direito de um cão com presença de Dioctophyma
renale [Case Report: Right kidney nephrectomy
in a dog with presence of Dioctophyma renale]. In: SIEPE – SALÃO INTERNACIONAL DE ENSINO,
PESQUISA E EXTENSÃO DA UNIPAMPA: SALÃO DE EXTENSÃO, 4. (n. 3), 2013, Bagé. Anais […]. Bagé:
UNIPAMPA, 2013. Available from: https://periodicos.unipampa.edu.br/index.php/SIEPE/article/view/63597.
Accessed on: 4 oct. 2022.
PICCOLI, R.J.; THOMAZONI, D.; DRUZIANI, J.T.;
HAMAMURA, M.; DE CARVALHO, A.L. Nefrectomia total
unilateral em cachorro-do-mato (Cerdocyon thous) [Total unilateral nephrectomy in a
crab-eating fox (Cerdocyon thous)].
Acta Scientiae Veterinariae, Porto Alegre, v.
45, suppl. 1, pub. 228, p. 1-6, 2017. Available from:
https://doi.org/10.22456/1679-9216.86162.
Appendix 1. Nephrectomy intervention and nephrectomized kidney.
Source: The authors.
Access on: https://drive.google.com/file/d/1qIuO9gzjiaa8fORXCEq0L0ctH3vg31ES/preview